Open AccessFibrinogen concentrations predict long‐term cognitive outcome in young ischemic stroke patients
Author(s) -
Pedersen Annie,
Stanne Tara M.,
Redfors Petra,
Viken Jo,
Samuelsson Hans,
Nilsson Staffan,
Jood Katarina,
Jern Christina
Publication year - 2018
Publication title -
research and practice in thrombosis and haemostasis
Language(s) - English
Resource type - Journals
ISSN - 2475-0379
DOI - 10.1002/rth2.12078
Subject(s) - medicine , fibrinogen , stroke (engine) , confounding , von willebrand factor , confidence interval , biomarker , cognition , physical therapy , platelet , psychiatry , mechanical engineering , chemistry , engineering , biochemistry
AbstractEssentials Cognitive impairment is frequent after stroke and knowledge on predictors is limited. We investigated hemostatic biomarkers as predictors of long‐term cognitive function after stroke. Fibrinogen, von Willebrand factor and tissue‐type plasminogen activator correlated to cognitive outcome. In young patients, fibrinogen was independently associated to worse cognitive outcome 7 years post‐stroke.Background Cognitive impairment is frequent after stroke, and young patients may live with this consequence for a long time. Predictors of cognitive outcomes after stroke represent a current gap of knowledge. Objectives To investigate levels of three hemostatic biomarkers as predictors of long‐term cognitive function after stroke. Methods This longitudinal study included consecutively recruited patients with ischemic stroke at 18‐69 years (n = 268). Blood was collected 3 months after index stroke and analyzed for plasma concentrations of fibrinogen, von Willebrand factor ( VWF ) and tissue‐type plasminogen activator (t‐ PA ) antigen. Cognitive function 7 years after index stroke was assessed by the Barrow Neurological Institute Screen for Higher Cerebral Functions ( BNIS ). Participants with stroke <50 years of age were also examined by the Trail Making Test A and B (n = 41). Associations between biomarker concentrations and cognitive scales were assessed in the whole group and in participants with stroke <50 years of age. Results The hemostatic biomarkers fibrinogen, VWF and t‐ PA , were all correlated to total BNIS score, but these associations did not withstand adjustment for confounding factors in the whole group. However, in patients <50 years, we found an independent association between fibrinogen concentrations and total BNIS score (β std = −.27, 95% confidence interval [ CI ], −0.47 to −0.07) and to performance on the Trail Making Test A (β std = .31, 95% CI , 0.03–0.58). No such association was seen for the Trail Making Test B. Conclusion High convalescent fibrinogen concentrations were associated with worse long‐term cognitive outcomes in ischemic stroke <50 years of age. We propose further investigations of fibrinogen in relation to cognitive function in stroke in the young.